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Thank you for standing by. This is the conference operator. Welcome to the Second Quarter Fiscal 2021 Financial Results Conference Call and Webcast for Quipt Home Medical. [Operator Instructions] And the conference is being recorded. [Operator Instructions] We remind you that the remarks today will include forward-looking statements that are subject to important risks and uncertainties. For more information on these risks and uncertainties, please see the reader advisory at the bottom of the company's results news release as well as the company's MD&A, which you can find on the website, SEDAR and as may be included on EDGAR. The company's actual performance could differ materially from these statements. At this point, I'd like to turn the conference over to Chairman and Chief Executive Officer, Greg Crawford.
Thank you, operator, and thank you all for joining us today on the call. My name is Greg Crawford, and I'm the Chairman and Chief Executive Officer of Quipt Home Medical. Joining me today is Hardik Mehta, our Chief Financial Officer. As we begin today's call, let me start by saying how excited we are to rebrand into Quipt Home Medical at such a pivotal time in our company's life cycle on the heels of our successful NASDAQ listing completed last week. We feel having a top-tier North American exchange behind us will open many doors for the company as we continue our growth trajectory. The Quipt motto is exceeding expectations, enriching lives as providing exceptional service isn't just something we do. It's who we are, and it's who we will always be. Quipt specializes in end-to-end respiratory care utilizing our interconnected health care platform, which leverages a sophisticated technology infrastructure and strong regional distribution footprint to streamline all phases of the delivery process. Known for our service-intensive model, ongoing patient education and in-home respiratory therapy services, we are able to operate a successful patient-centric ecosystem throughout the organization. This is the main driver behind our robust growth as an organization and what has allowed us to further increase our market share by penetrating new and existing markets. Our people are the foundation of every successful metric within our organization, and I cannot be more pleased to see firsthand the passion for patient care displayed every day. We have our focus geared towards growing into a national home care provider in the United State and believe we have the organic growth plan and robust acquisition pipeline to help us get there. With the substantial financial resources, operational fortitude and strongest regulatory environment we have had in a decade, we are provided with an extremely bullish outlook for the future. We have readied our infrastructure platform to allow us to effectively leather on revenue, expansion of our geographical footprint and add additional talent across the organization. All aspects are a part of the strategy as we become a national leader in respiratory care across the United States. At present, Quipt operates out at 51 locations in 11 states across the Midwest, Southeast and East Coast regions, completing hundreds of thousands of deliveries each year to more than 120,000 active patients with over 17,000 referring physicians. On this call, I will provide an update on the bullish regulatory landscape, which is the best in the last decade, update our core business, which continues to be very strong with a focus on our record-breaking second quarter fiscal 2021 results. On the regulatory front, we continue to see bullish momentum as the centers for Medicare and Medicaid Services, CMS, published a new oxygen fee schedule that resulted in an increase in reimbursement for oxygen rates nationwide beginning April 1, 2021. According to the American Association for Home Care, as a result of the new fee schedule, an increase of approximately 5% to 11% will be felt across the industry for oxygen products. Quipt's current oxygen business, which represents nearly 23% of its overall product mix, and this decision by the CMS provides a significant boost to the already robust tailwinds lifting the underlying business. It is evident that home-based care for the growing population of elderly Americans is crucial and reducing the burden on hospitals, nursing homes and other senior living facilities is imperative. The CMS decision to increase oxygen rates will assist the industry and economically fulfilling the patient demand for these products. Also, I believe it is again worth noting one of the major tailwinds propelling our industry comes from the decision made last October by CMS to cancel the 2021 competitive bidding program for 13 product categories. The cancellation of this program has provided us a clear margin outlook across our product mix and ensured our patient stability. It is important to note that the CMS stated that the program did not achieve the expected savings, which we believe the reimbursement rates have likely near to floor, and there is no Medicare reimbursement rate cut risk for the foreseeable future. Turning to the underlying business. We continue to see strength across our heavily weighted respiratory product mix, highlighted by a substantial rebound in our sleep services offering in the second quarter as restrictions have eased and continue to ease across our geographical footprint, we are confident this trend in our sleep business will remain favorable and expect strong sustained growth for the remainder of the year. The first rate infrastructure we have in place today allows us to position ourselves as a market leader and gives us the flexibility to add locations organically to the platform as well as efficiently integrate acquired assets. I am extremely excited to share. We experienced a significant amount of growth in our recurring revenue base during the first half of 2021 with recurring revenue now representing approximately 75% of our overall revenue. This increase in our recurring revenue provides us further stability and consistency as we look at our growth outlook, business model and financial reporting. We are proud with the results displayed in the second quarter once again seeing the consistency of our model in full display with revenue reaching $24 million and EBITDA margins remaining above 22%, we have seen our business in Q3 2021 remain robust and continue to be in a position to accelerate our growth trajectory over the near and medium-term as we look to further our long-term acquisition strategy. With the team we have built, first rate infrastructure we have created and clear regulatory outlook, we are in an excellent position to add and integrate turnkey respiratory companies to our platform with ease. This gives us the opportunity to aggressively scale the business as we move through 2021 and beyond. With that background, I'd like to hand the call over to Hardik to discuss our second quarter 2021 financial results.
Thanks, Greg. Yesterday evening, we announced our second quarter financial results for fiscal 2021, representing the 3 months ended March 31, 2021. In reviewing the second quarter fiscal 2021 numbers, please note that all financial values are in U.S. dollars and the full results are available on SEDAR and as may be included on EDGAR. Here are some key highlights. In the second quarter of fiscal 2021, Quipt completed 83,606 setups or deliveries compared to 63,956 in the corresponding period last year, an increase of 31%.In the second quarter of fiscal 2021, Quipt completed 35,702 respiratory resupply setups or deliveries compared to 13,980 in the corresponding period last year, an increase of 155%. The company generated revenue of $24.2 million in the second quarter of fiscal 2021, up 37% from second quarter fiscal 2020. Not factoring acquisitions, the organic growth year-over-year was approximately 11%. The company's recurring revenue continues to grow and exits 75% of total revenue. For the 6 months ending March 2021, bad debt expense was 9.1% of revenue compared to 10.5% for the same period in 2020, an improvement of 1.4%. This exemplifies our ability to scale and add more revenue through add-on acquisitions without compromising our billing capabilities. For the 6 months ending March 2021, operating expenses excluding bad debt expense, reduced from 47.3% of revenue to 42.5% of revenue, once again, reinforcing our ability to leverage our infrastructure and platform for additional marginal increase in revenue. Adjusted EBITDA for second quarter of fiscal 2021 was $5.4 million compared to $4.1 million for the second quarter of fiscal 2020, representing a 29% increase year-over-year. Adjusted EBITDA margin for second quarter of fiscal 2021 continues to be strong and was at 22.2% for the quarter. Cash flow from operations for the 6 months ending March 2021 was $6.6 million compared to $5.2 million in the corresponding period ending March 2020. Current assets totaled more than $48.7 million compared to $33.3 million in net short-term liabilities, demonstrating continuing strength in our liquidity. At the end of second quarter fiscal 2021, cash balance was $27.2 million compared to $23.6 million at December 31, 2020. At the end of second quarter of fiscal 2021, the company has an undrawn revolving credit facility of USD 20 million. We continued to experience sustained strong growth across our product mix, highlighted by heightened demand for oxygen equipment and ventilators. Furthermore, it is worth noting the strong demand continues to process in fiscal Q3. We were also pleased to see a lift in our sleep therapy business with reopenings happening throughout our geographical footprint and expect the trend in this category to remain favorable. Moreover, the reopening is also allowing us to begin reaching touch points that had not been available over the past year, which will allow us to ramp up on the sales front. Furthermore, we remain extremely pleased with our operating performance through the second quarter and are seeing strong market conditions continue to persist, and we believe they are here to stay. Our infrastructure allows us to scale quickly and the robust financial position we have provides us the ability to target meaningful acquisitions candidate that work significantly to move the needle for our coverage beer in the United States. We expect to have a very busy second half of the year as it relates to our M&A program and organic growth initiatives. In closing, with our successful NASDAQ listing now behind us, we look forward to accelerating on our M&A strategy, with $27 million in cash and an untapped $20 million credit facility, we strongly believe in our ability to add substantial revenue at a very fast pace. We are expecting a busy second half on this front. We will continue our disciplined capital allocation strategy, furthering our strategic goals and are more confident than ever in our market position and ability to quickly increase our scale. Thank you. And with that update, I'll turn the call back to Greg.
Thanks, Hardik. The first half of 2021 has been extremely successful for the Quipt team. We saw solid organic growth of 13% through the first 2 quarters of fiscal 2021, entered new geographies, both organically and inorganically, rebranded the organization to provide us significant opportunity in our local markets as well as continuing to provide superior patient care. Additionally, we have continued to experience increased patient demand for respiratory equipment, including ventilators and oxygen concentrators as well as our CPAP resupply and other supplies business. As mentioned earlier, our sleep business which saw the steepest declines within our product mix year-over-year during the height of the pandemic has seen a strong rebound exiting Q2. We are confident this business will surpass historic levels as we move through the remainder of 2021. Sleep therapy has been a keen area of focus for us and the underlying trends continue to signal long-term strength in this segment. According to the American Sleep Apnea Association, sleep disorders, including sleep apnea, have become a significant health issue in the United States. It is estimated that 22 million Americans suffer from sleep apnea, with 80% of the cases of moderate and severe obstructive sleep apnea undiagnosed.It is also worth noting, we expect as the pandemic and related restrictions ease, we can achieve better organic growth rates driven by acquiring additional sales talent across our markets. Across the industry, we are seeing strong trends in 2021 when it comes to the importance of home care, whether it be patients, referral sources, payers or lawmakers, it is clear the structural shift is well underway to ensure a patient is treated in a home care setting whenever possible. Our team has been focused on finding the optimal ways to grow relationships with referral sources, and we are seeing the benefits of this across the organization. Our efforts of communicating to physicians and patients through our technology platforms have certainly paid off. We have been nimble and proactive as it comes to our approach with patients giving us the ability to adapt to the daily needs of our patients in large part due to our investments over the past few years in cloud-based technology across our back office and patient-facing functions. Our infrastructure allows us to leather on organic opportunities to help scale our reach, and we have done just that. In March, we opened 2 de novo locations to continue building scale throughout our current operating footprint. The ability to buy-and-build while supplementing our operating footprint with de novo locations will provide us ample flexibility when serving a new market and be a key driver for long-term success. In February, we acquired Mayhugh’s Medical Equipment in Jacksonville, Florida, to begin building that foundation in Florida, our newest geography. This gives us a starting point in which to navigate with 10,000 new active patients. Now, I want to take a moment to explain in a little more depth what we are doing differently and why we have been able to achieve the results we have and why we continue to be so excited about the future. We continue to successfully deploy a highly scalable connected healthcare platform focused on organic sales generation, accretive acquisitions with efficient capital deployment, targeted margin expansion and cash generation. This model also encourages compliance, improved outcomes and drive engagements with patients. Moreover, we can drive early interventions, reduced hospitalizations and monitor treatment plan effectiveness which all serves as a benefit to the payers. I would now like to review with you the 3 components of our growth strategy. First, we are laser-focused on capturing market share economically and profitably. Our industry growth rate is about 5% to 6% per year. However, we believe we can continue to significantly outpace the industry growth rate by focusing on significantly increasing our market share in key target regions within the markets we serve as well as opening up new markets. Secondly, as we continue to lead the industry in technology deployment and our use of data mining tools to drive efficiencies and profitability, an example will be our robust subscription-based model for resupply, which provides meaningful revenue synergies for us on the acquisition front. The third component of our growth strategy is acquisitions. We are looking for turnkey respiratory operations that can be seamlessly integrated into our highly scalable platform. As we look at M&A, we have 3 facets to our acquisition approach. The first being a focus on scale and hence, targeting companies in the revenue range of $5 million to $20 million, with consistent annual EBITDA margins between 10% and 20% plus and large distribution volume, which can be leveraged by our platform. The second facet, being focused on scaling into a national provider by acquiring sub $5 million revenue target with strategic goal of expanding our payer mix and expanding our geographical footprint across new states, allowing us to become a national provider. The third facet being substantially larger opportunities that will be more meaningful from a revenue, EBITDA, patient-based and geographical reach standpoint. We are working through a robust pipeline and expect a very busy second half of the year. We are ready to make the lead from a regional to national respiratory provider and have the tools needed to execute our path forward. On the capital markets front, we have reached our most significant milestone to date with the commencement of trading on the NASDAQ last week. As I look at the evolution of our company, I am so proud of the entire team for their hard work and dedication to going above and beyond, and this is a culmination of those efforts. We feel this NASDAQ listing will assist us in broadening and strengthening our shareholder base, enhancing liquidity and assist us in garnering awareness for our growing company. All of this, coupled with continued business execution, should assist us, including the valuation gap. For the remainder of the year, we will be very active on both sides of the border to ensure we use this valuable stepping stone to engage with investors. Additionally, we look forward to keeping everyone updated as to conferences we will be attending. We have spent years crafting our platform, and it is truly at an inflection point which is poised for growth. Given the current landscape of the industry, we must remain active in capturing the many opportunities that exist in front of us and we have all the tools to do so. We cannot be more excited for what the future holds for Quipt and our more than 120,000 active patients we care for. Once again, I would like to take a moment to thank the entire Quipt team for its tireless efforts and its stakeholders for all their continued support.
[Operator Instructions] Our first question comes from Doug Cooper with Beacon Securities.
Congratulations on another nice quarter. A couple of things just first off. So organic growth, 11%, that's very good. Mayhugh Medical, I think I saw in the MD&A, was $1 million in the quarter. So what are you -- is there -- that was 2 months of contribution, I guess, right, at the end of the day from Mayhugh?
Yes, it was about 2 months.
So is that -- it's on run rate of USD 6 million. Is that fair?
Yes, that's fair.
Yes.
Approximately $6 million, yes.
Okay. And the EBITDA margin, it was lower than, I guess, your guys, I think, was -- contributed $100,000, I think you'd said in the MD&A, so it's a 10% margin you guys are 22%. How quickly do you think you can get their margins up to yours? And what's its organic growth rate? I guess we'll start there.
So yes, what you have on the MD&A is its net income, not EBITDA, right, Doug. So that definitely is a different number. I think we expect the EBITDA to be usually, for acquisitions like that. We expect our EBITDA to be better than our overall EBITDA for the company because the overall company has corporate expenses and stuff like that. So we expect that to be substantially more than our -- the 22% that we currently have?
Okay. And what's its organic growth rate?
It typically takes about 1 to 2 full quarters, Doug, to get it integrated.
Okay. And does it experience a growth rate similar to yours?
Yes. Actually, it is doing really well.
Okay. You noticed -- I noticed on your last call, you gave some targets of $135 million in revenue, I guess, a near-term target and 22% EBITDA margin. Obviously, you're there on the margin side. And then the longer-term $250 million at 25%. Not far off the $135 million, you certainly got the firepower in terms of the cash and the undrawn credit facility to get that done. Do you want to give us sort of time frame? And when do you think you'd be at that when you'd hope to be at that $135 million run rate?And just in terms of M&A, you obviously just put a toll hold in putting the water in Florida, a huge market opportunity, given the aging population probably there. Is that a geographic or an area that you would like to expand in? And I'll turn it over to others.
Yes, absolutely. And that we've already opened one location in Florida, wherein some other territories down there with additional sales representation. So we do plan to expand in Florida. As far as the M&A and reaching that $135 million on a run rate by the end of the calendar year is our goal. I know this year, when we started, we were at $100 million run rate by the end of the calendar, we almost reached it in that by the end of the physical year and that we expect to have a busy second half of the year. And that with M&A, especially with the $27 million in cash, the $20 million bank line and that with CIT, which we view as a partner and has the ability and that for upside. So we continue to stay laser-focused on acquisitions that are more meaningful in that in size and revenue and also in that, it will expand our geographical footprint.
Our next question is from Justin Keywood with Stifel GMP.
On the organic growth in the quarter, was there a particular category that was driving that, the 11% overall, if it was the sleep or the Respiratory services?
It definitely was a combination of all, but certainly, sleep oxygen and ventilators were the key drivers. On the sleep side, even though we -- there were some setups due to COVID issues, but I think we did a phenomenal job on our resupply platform that was put in place in Q3 of 2020.
Okay. And in the opening remarks, there was comments that the sleep business is seeing very high activity exiting Q2. Are you able just to comment on the expected organic growth for the remainder of the year?
This is Greg. I couldn't put a number on what the organic growth is from a dollar-wise right now. And that -- what I will say is that the sleep business had been very flat in that and there hasn't been much growth in it. So now we're actually just starting to see growth in new patient setups and that for devices.And it seems to be taken off rather quickly. And that especially if things have opened up, we're getting into the second half of the year where insurance deductibles are less of a headwind than they are in what was just published here with our Q2, which is calendar Q1. So going into Q3 and that new device setups has been really strong.
Okay. And is there any pandemic-related organic growth that contributed in the quarter? Or do you anticipate any growth related to that transitioning off and perhaps the sleep business coming back more strongly? Any comments around that could be helpful.
Yes. So primarily during the pandemic in that we've seen an increase in our oxygen business, but that continues to remain very, very strong. And now with the addition of sleep coming back on, also the resupply business in that, which was kind of a big driver during the pandemic also in the height of it, and that continues to remain very strong, just as Hardik mentioned in that. So we still kind of those categories that did fuel our growth in 2020 and that continue to remain strong going into 2021.
Okay. And then finally, just on M&A. Are you able to describe your pipeline just as far as the number of targets that you're looking at currently in the near-term and then just more broadly based?
Sure. We do have a very robust platform. The number of targets in size if you talk about numbers. We have probably 15-plus targets, cumulative value of revenue. It's a broad range because some targets are small and some targets are big. But it's a broad range of somewhere in that $75 million to $150 million. That's the pool that we currently have, and it continues to get filled on a weekly basis.We are looking at larger deals. We would love to do deals that would move the needle for us. But at the same time, as we made comments on the opening copies where we will continue to look at strategic additions as well. So if there is a smaller target that would allow us to get into a new geography, into a new payer mix, we wouldn't shy away from it because it's not big enough. We'll definitely go in and execute on that as well. So it's a combination of strategic and, of course, scale.
And just to clarify, that's 15, 1-5 potential targets?
Yes. In terms of number of deals that we are currently actively looking at, yes.
Our next question is from Rahul Sarugaser with Raymond James.
I think Doug and Justin kind of asked most of the questions I was going to ask, but I just wanted to follow-on a little bit from Justin's question on the M&A. So you -- Hardik, you referred to having a preference for these larger transactions to move the dial. Are you finding -- what is the rate-limiting step there in terms of being able to do these early transactions? Are they commanding higher multiples and that you're not willing to pay that? Or are they just a few or further between? Maybe give us a little color in terms of the landscape of smaller versus larger transactions that you could capitalize on?
No. I think it's a combination of people wanting to just see how the pandemic was turning out for them. So there was a little bit of a slowness earlier part of the year. I think now that everybody is seeing that it's beyond that. So a lot of the sellers are kind of popping their head up and trying to reevaluate where the M&A market is.It's not where they are necessarily asking for a higher valuation as such. I think we just want to be very selective in what we do, and we want to make sure that we make the right decision for our shareholders.
Got it. Got it. Then a follow-on question then is with the recent Quipt branding, how do you see that -- the broadening of your branding of Quipt across the organization affecting the overall business, being able to secure contracts, both organic and inorganic growth.
Yes. So the rebranding in that, we thought that we were at a real inflection point in that -- in the company and that to do that. And looking at some of our potential acquisitions and even some that we've done in the past and that where we have overlap of names in certain markets, we thought it was going to be a good time to start potentially changing some of the names of those companies as we continue to work towards becoming a national provider and really start branding ourselves. So we think that's something that will come over time.
Our next question is from Stefan Quenneville with Echelon Capital Markets.
And congratulations on all the progress you made in the last quarter, you've been clearly very busy, but in listed on the NASDAQ. Can you guys talk a bit about your trends in bad debt and sort of put them in context? As well, are you expecting any sort of meaningful costs associated with your rebranding efforts?
I heard the question around bad debt. I think what you see for the year-to-date is pretty resemblance of what we expect -- where we expect it to be plus/minus a point here and there. And what was the second question? I did not get the second question.
Yes. Sorry about that. Are you expecting any sort of meaningful costs associated with your rebranding?
Not meaningful. I mean, something ordinary for an exercise like this, I wouldn't call it meaningful. It was already -- a part of that was already in the quarter, a part of that will be in Q3, so.
Our next question is from Dick Ryan with Colliers.
Congratulations guys on very strong execution. Greg, you mentioned sales force expansion with the pandemic winding down. Can you put some context around that? What you -- where your sales force is today and what your anticipation is going forward?
Yes, sure. So we approximately in that have about 40 sales reps now in that, and we're going to look to increase that and that's somewhere in that 20% to 40% range herein that by the end of the year. We're very, very active right now in interviewing in that potential candidates.We've identified a lot of target markets. And as we continue to work through and make sure that those physicians' offices are open, hospitals are open, and they're actually able to make contact, and that's when we'll continue to add those. But we're really liking what we see right now at this point in time.
Okay. And on your market share gains, where have they been?
I mean it's primarily been everywhere and that there's no particular region in that that's taken off any better than another. So that continues to remain very robust and that's really across the entire organization. Everybody is really contributing right now.
Okay. With the uplisting, obviously, the hope is to get broader share ownership, both sides of the borders. But with M&A, is it possible to use stock as a currency now with a NASDAQ-listed company? Or are these acquisitions generally just all cash?
It's funny you ask because we prefer to use our cash on the balance sheet. We value our stock more than the cash we have on the balance sheet, looking into 2021 and 2022. However, there has been transactions where we have used stock, and it was more a way for us to cater to the seller's need or request rather than us wanting to do -- use our stock as a currency.
Our next question is from Bill Sutherland with Benchmark Company.
Great work this quarter. Most of my questions have actually been asked. There's a couple in M&A, I think I'll follow up on. And one is, as you get into markets, particularly like Florida and given all the capital, seems to be getting attracted to the space. What about valuations? Are you in a strong pipeline and are the parameters in terms of valuation pretty much in line?
You mean to say valuation of the companies we are acquiring or look forward to acquiring?
Yes.
Yes. I mean, we are not seeing any dramatic changes in the valuation in the industry as such. A lot of the deals that we work on are also self-generated. And again, we spend an enormous amount of time understanding these companies and who they are and what the seller wants. And I think we take a distinguished approach than the other nationals. And I think our USP is who we are and what we do post-close for the sellers and the employees, apart from what it does for the company.So we don't see challenges when it comes to multiples compared to other nationals or what they are paying and stuff like that. I think we are pretty much at par or better as an overall package when it comes to the deals that we look at. If they have to compare apples-to-apples with what Quipt brings to the table versus the other consolidator it brings to the table, I think we have a better package to offer.
And is your pipeline, since you have entered a new market here with Florida, do you have more new markets in mind? Or do you expect a more of a density strategy this year or next year?
It's going to be a combination of expanding into the geography so it's not just the density. Definitely, that helps, but we would also infiltrate it into the other parts of Florida that we are not into right now. I think we will definitely grow into Florida as a state. Our revenue from that state is definitely expected to increase substantially over the next couple of years.
And then finally, on service lines. I'm curious if also some of the pipeline has anything that would be incremental to your current mix? I know you're very focused on respiratory, obviously, because of the clinical service component. Is there any other service lines that might be attractive, that might be something you could bring in with the right acquisition?
Yes. So currently, in that everything is respiratory focused on that. We continue to stay laser-focused on that particular category in that. We believe that our clinical programs and follow-up programs that we have running behind the themes in that are second to none, and that's really what's driving our profitability. It's driving our growth. So we've just continued to stay focused on those at the present time.
This concludes the question-and-answer session. I would like to turn the conference back over to Greg Crawford for any closing remarks.
Thank you, operator, and thank you all for your participation today. As always, you can find us on the web at quipthomemedical.com, where will we be posting our new website and also a copy of this transcript and also our updated investor deck. On the site, you can also view some of the exciting products and developments discussed on this call. Have a great day.
This concludes today's conference call. You may disconnect your lines. Thank you for participating, and have a pleasant day.